That's not generally true. From [0]

> Across most states, viewing CSEM alone is generally not a mandated-reporting trigger; reporting becomes obligatory when disclosures involve an identifiable child being abused or used to produce material.

> California’s CANRA imposes a distinct duty to report electronic access (download/stream) with identifying patient information, upheld against privacy challenges based on compelling state interest.

[0] https://www.psychiatrictimes.com/view/mandatory-reporting-ch...